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NPI Code Detail

MEDICARE: GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING

MEDICARE: GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336L0003XLong Term Care PharmacyHSP48566CA
2314000000XSkilled Nursing Facility550000621CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487681631
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING
Provider Business Mailing Address
First Line : 7150 TAMPA AVE
Second Line :
City : RESEDA
State : CA
Zip : 91335-3700
Country : US
Telephone Number : 818-774-3000
Fax Number :
Provider Business Practice Location Address
First Line : 7150 TAMPA AVE
Second Line :
City : RESEDA
State : CA
Zip : 91335-3700
Country : US
Telephone Number : 818-774-3000
Fax Number :
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : SHERRI CUNNINGHAM
Credential :
Telephone Number : 818-774-3000
Provider Enumeration Date : 06/26/2006
Last Update Date : 11/13/2008

Similar Medicare Providers

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Practice Location Address:
7150 TAMPA AVE
RESEDA, CA
91335-3700
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Practice Fax:
1417950163 — GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING
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7150 TAMPA AVE
RESEDA, CA
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Practice Fax:
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RESEDA, CA
91335-3700
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Practice Fax:
1932130861 — DR. RICK SMITH M.D.
Practice Location Address:
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RESEDA, CA
91335-3700
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Practice Fax:
1972601037 — HANGNGA VU M.D.
Practice Location Address:
7150 TAMPA AVE
RESEDA, CA
91335-3700
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1902979552 — ANN C. KEREN-ZVI
Practice Location Address:
7150 TAMPA AVE
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91335-3700
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Practice Fax:

Directions to “GRANCELL VILLAGE OF THE LOS ANGELES JEWISH HOME FOR THE AGING ” Practice Location

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